Minimally invasive surgery has proven to be a valuable tool by providing an enhanced recovery to patients undergoing procedures such as a cholecystectomy. There is much enthusiasm and interest in applying this tool to more complex and less frequently performed procedures such as the pancreaticoduodenectomy. While the feasibility of applying minimally invasive surgery to the pancreaticoduodenectomy has been demonstrated, there is a challenge to see beyond equivalency with its open counterpart during the early phase of the learning curve. To clarify the benefit of this technique a review of series from high volume centers is needed. Beyond technical feasibility and outcome variables there must also exist the ability to teach this technique to surgical trainees to enable widespread adoption and for the minimally invasive pancreaticoduodenectomy to stand the test of time.
Kenneth Leung, Alexander Perez